Healthcare Provider Details

I. General information

NPI: 1114848322
Provider Name (Legal Business Name): EASTERN KENTUCKY INTEGRATED HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6263 HIGHWAY 119
WHITESBURG KY
41858
US

IV. Provider business mailing address

PO BOX 517
FLEMING NEON KY
41840-0517
US

V. Phone/Fax

Practice location:
  • Phone: 606-634-4598
  • Fax: 606-832-0194
Mailing address:
  • Phone: 606-634-4598
  • Fax: 606-832-0194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENDA J. BAKER
Title or Position: PRESIDENT
Credential: MD
Phone: 606-634-4598